SMART Health Cards: Vaccination & Testing Implementation Guide
0.6.2 - STU 1 (Ballot Version)

SMART Health Cards: Vaccination & Testing Implementation Guide, published by HL7 International - Public Health Work Group. This is not an authorized publication; it is the continuous build for version 0.6.2). This version is based on the current content of https://github.com/HL7/fhir-shc-vaccination-ig/ and changes regularly. See the Directory of published versions

Artifacts Summary

This page provides a list of the FHIR artifacts defined as part of this implementation guide.

Structures: Resource Profiles

These define constraints on FHIR resources for systems conforming to this implementation guide

COVID-19-specific Laboratory Test Results Bundle - Allowable Data

The bundle of resources that represents the patient identification and clinical content of a SMART Health Card with lab results, specifically for COVID-19.

COVID-19-specific Laboratory Test Results Bundle - Data Minimization

The bundle of resources that represents the clinical content of a digital lab credential record specifically for COVID-19 data minimization.

COVID-19 Laboratory Result Observation Profile - Allowable Data

Profile for reporting COVID-19-related laboratory results indicating current or previous infection status.

COVID-19 Laboratory Result Observation Profile - Data Minimization

Profile for reporting COVID-19-related laboratory results indicating current or previous infection status. Only elements necessary for Verifiers can be populated.

Infectious Disease (Generic) Laboratory Test Results Bundle - Allowable Data

The bundle of resources that represents the patient identification and clinical content of a SMART Health Card with lab results.

Infectious Disease (Generic) Laboratory Test Results Bundle - Data Minimization

The bundle of resources that represents the patient identification and clinical content of a SMART Health Card with lab results.

Generic Laboratory Result Observation Profile - Allowable Data

Profile for reporting laboratory results indicating current or previous infection status for a disease without a specified laboratory result profile.

Generic Laboratory Result Observation Profile - Data Minimization

Profile for reporting laboratory results indicating current or previous infection status for a disease without a specified laboratory result profile. Only elements necessary for Verifiers can be populated.

Patient Profile - General - Allowable Data

Slight modification of Patient, with identifier as 0..0 and limited MS. For general use if no geographic-specific profile exists.

Patient Profile - General - Data Minimization

Only elements necessary for Verifiers can be populated. For general use if no geographic-specific profile exists.

Patient Profile - United States - Allowable Data

Only elements necessary for Verifiers can be populated.

Patient Profile - United States - Data Minimization

Only elements necessary for Verifiers can be populated. For use in the United States.

Vaccination Profile - Allowable Data

Defines a profile representing a vaccination for a SMART Health Card.

Vaccination Bundle - Allowable Data

The bundle of resources that represents the patient identification and clinical content of a SMART Health Card for vaccinations.

Vaccination Bundle - Data Minimization

The bundle of resources that represents the patient identification and clinical content of a SMART Health Card for vaccinations.

Vaccination Profile - Data Minimization

Defines a profile representing a vaccination for a SMART Health Card. Only elements necessary for Verifiers can be populated.

Terminology: Value Sets

These define sets of codes used by systems conforming to this implementation guide

Identity Assurance Level

Relevant identity assurance level codes, based on NIST 800-63-3. See <https://smarthealth.cards/ial> for details.

Lab result findings

This value set includes SNOMED CT and LOINC codes for identifying laboratory test results.

Note that we plan to change this value set to include only children of 441742003 (“Evaluation finding (finding)”) instead of 404684003 (“Clinical finding (finding)”), but currently value set expansion is not working with this code in the IG Publisher.

Lab result findings - SNOMED CT

This value set includes SNOMED CT codes for identifying laboratory test results.

Qualitative lab result findings

This value set includes codes for identifying laboratory test results. It includes SNOMED CT codes from a value set of COVID-19-related SNOMED CT codes, as well as codes from LOINC answer lists with roughly equivalent meanings. While the source value set is COVID-19-related, these codes should apply to all infectious disease-related qualitative laboratory results.

Qualitative lab results - LOINC

This value set includes codes from LOINC answer lists with roughly equivalent meanings to the codes in this value set of COVID-19-related SNOMED CT codes.

Vaccine: ATC/DDD

This value set includes the subset of ATC that identify vaccine targets.

Note that an ATC code for COVID-19 vaccines (J07BX03) has been created and will be added to the next published version of ATC/DDD slated for January 2022.

Vaccine: CVX

This value set includes all CVX codes, which identify vaccine products.

Vaccine: GTIN

This value set includes all GTIN codes, rather than just the vaccine-related GTINs. This is because there is not a way to filter GTINs to a specific category of product. For more information about GTINs see the Vaccination profile group information page.

Vaccine: ICD-11

This value set includes the subset of ICD-11 that identify vaccine types.

Note that the COVID-related ICD-11 vaccine codes are not in the 09/2020 version of ICD-11. They can be found on the maintenance platform, and include:

  • XM1NL1: COVID-19 vaccine, inactivated virus
  • XM5DF6: COVID-19 vaccine, live attenuated virus
  • XM9QW8: COVID-19 vaccine, non-replicating viral vector
  • XM0CX4: COVID-19 vaccine, replicating viral vector
  • XM5JC5: COVID-19 vaccine, virus protein subunit
  • XM1J92: COVID-19 vaccine, virus like particle (VLP)
  • XM6AT1: COVID-19 vaccine, DNA based
  • XM0GQ8: COVID-19 vaccine, RNA based

Implementers should consider the ICD-11 maintenance platform the canonical source of ICD-11 codes for COVID-19 vaccines.

Note that this value set should contain the same codes as the WHO Vaccine List value set, and may be replaced with the WHO value set once that is published.

Vaccine: SNOMED CT

This value set includes codes identifying vaccine products from SNOMED Clinical Terms®, specifically descendants of 787859002 (“Vaccine product”).

Descendants of this code from any edition of SNOMED CT MAY be used in elements bound to this value set. All SNOMED codes regardless of edition share the same canonical URI (http://snomed.info/sct), which means that from a conformance perspective, this value set does not differentiate between SNOMED CT editions.

However, successfully validating resources with elements bound to this value set requires a terminology server that supports the SNOMED edition used by the implementer.

The terminology server used for publishing this Implementation Guide (tx.fhir.org) supports the following SNOMED CT editions as of publishing:

  • International
  • Australia
  • Canada

The relevant codes from these SNOMED CT editions are included in the value set expansion below.

Note that this value set expansion may be out of date, and may not include COVID-19-related codes. Implementers SHALL defer to the canonical list of COVID-19-related SNOMED International codes, or the national edition equivalent, for COVID-related vaccines when it does not match the codes listed below.

Note that some of the SNOMED-CT codes that are part of this value set expansion, including the COVID-19-related SNOMED codes, may be used under the a Creative Commons Attribution 4.0 International License as part of the SNOMED Global Patient Set. Please refer to https://gps.snomed.org to determine which specific SNOMED codes may be used under this license.

Terminology: Code Systems

These define new code systems used by systems conforming to this implementation guide

Identity Assurance Level Code System

Code representing identity assurance level, based on NIST 800-63-3